No abstract

Pseudocyst is one of the commonest complications following pancreatitis. However, a mediastinal pseudocyst is a rare entity which demands a high index of suspicion for diagnosis. We report a case of a 42 years old male who presented to the emergency with cough, retro-sternal chest pain, progressive dysphagia and vomiting. He was a chronic alcoholic with multiple hospitalisations in past 4 years for recurrent episodes of severe acute pancreatitis. There was left sided pleural effusion on chest radiograph and extrinsic compression of distal oesophagus and proximal stomach from posterior aspect on endoscopy. Abdominal computed tomography (CT) revealed a large pseudocyst abutting the body of pancreas and extending superiorly into the mediastinum. Patient was treated conservatively and given total parenteral nutrition followed by Ryle's tube feeding. He improved, started accepting orally and was discharged. Patient was asymptomatic on follow up and repeat CT scan after 6 weeks showed signicant decrease in the size of collection

In spite of a steep learning curve, laparoscopic Totally Extraperitoneal repair (TEP) promises less wound complications and shorter hospital stays over Lichtenstein's repair for primary unilateral inguinal hernia. We randomly allocated 50 male patients with primary unilateral inguinal hernia into two groups (21 in TEPgroup and 29 in open group) during a one year period and followed them up for a minimum of 3 months. Mean duration of surgery was 88.00 ± 28.12 minutes in laparoscopic repair versus 77.97 ± 22.22 minutes for open repair (p = 0.30). TEP group had signicantly lesser wound complications overall (p = 0.004), signicantly shorter mean post-operative stay (p< 0.001) and earlier return to occupational work (p< 0.00001). The incidence of groin pain at 3 months was again less in the TEP group (p = 0.70) with similar recurrences in both groups. So, TEP did not lead to increased recurrence but surprisingly offered better post-operative outcomes than Lichtenstein's repair.

No abstract

No abstract